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Omalizumab food allergy

Roxane Labrosse, François Graham, Anne Des Roches, Philippe Bégin
Food allergy is an important health issue that affects up to 8 % of the population. The management of allergic patients involves allergen avoidance and prompts the treatment of accidental reactions, as no curative treatment is available so far in routine practice. Oral immunotherapy (OIT) is a promising therapeutic alternative, but it is associated with frequent allergic reactions and cost-effectiveness issues. In hopes of reducing such reactions, a number of trials have used omalizumab, an anti-IgE monoclonal humanized antibody, as adjunctive therapy in OIT...
September 14, 2016: Archivum Immunologiae et Therapiae Experimentalis
Hern-Tze Tina Tan, Kazunari Sugita, Cezmi A Akdis
PURPOSE OF REVIEW: The development of biological therapies has rapidly progressed during the last few years, and major advances were reported for the treatment of allergic diseases, such as atopic dermatitis, allergic rhinitis, urticaria, food allergy, and asthma. Here, we review biologicals targeting the type 2 immune response involving Th2 cells, type 2 innate lymphoid cells, natural killer T cells, mast cells, basophils, and epithelial cells, such as IL-4, IL-5, IL-13, IL-31, tumor necrosis factor alpha (TNF-α), and thymic stromal lymphopoietin (TSLP)...
October 2016: Current Allergy and Asthma Reports
Andrew J MacGinnitie, Rima Rachid, Hana Gragg, Sara V Little, Paul Lakin, Antonella Cianferoni, Jennifer Heimall, Melanie Makhija, Rachel Robison, R Sharon Chinthrajah, John Lee, Jennifer Lebovidge, Tina Dominguez, Courtney Rooney, Megan Ott Lewis, Jennifer Koss, Elizabeth Burke-Roberts, Kimberly Chin, Tanya Logvinenko, Jacqueline A Pongracic, Dale T Umetsu, Jonathan Spergel, Kari C Nadeau, Lynda C Schneider
BACKGROUND: Peanut oral immunotherapy is a promising approach to peanut allergy, but reactions are frequent, and some patients cannot be desensitized. The anti-IgE medication omalizumab (Xolair; Genentech, South San Francisco, Calif) might allow more rapid peanut updosing and decrease reactions. OBJECTIVE: We sought to evaluate whether omalizumab facilitated rapid peanut desensitization in highly allergic patients. METHODS: Thirty-seven subjects were randomized to omalizumab (n = 29) or placebo (n = 8)...
September 5, 2016: Journal of Allergy and Clinical Immunology
Andrew H Liu, William C Anderson, Cullen M Dutmer, Daniel A Searing, Stanley J Szefler
In 2015, progress in understanding asthma ranged from insights to asthma inception, exacerbations, and severity to advancements that will improve disease management throughout the lifespan. 2015's insights to asthma inception included how the intestinal microbiome affects asthma expression with the identification of specific gastrointestinal bacterial taxa in early infancy associated with less asthma risk, possibly by promoting regulatory immune development at a critical early age. The relevance of epigenetic mechanisms in regulating asthma-related gene expression was strengthened...
August 2016: Journal of Allergy and Clinical Immunology
Oliver T Burton, Amanda J Stranks, Jaciel M Tamayo, Kyle J Koleoglou, Lawrence B Schwartz, Hans C Oettgen
BACKGROUND: Food allergy is a growing health problem with very limited treatment options. Investigation of the immunologic pathways underlying allergic sensitization to foods in humans has been greatly constrained by the limited availability of intestinal tissue and gut-resident immune cells. Although mouse models have offered insights into pathways of food sensitization, differences between rodent and human immune physiology limit the extension of these findings to our understanding of human disease...
June 8, 2016: Journal of Allergy and Clinical Immunology
Odelya E Pagovich, Bo Wang, Maria J Chiuchiolo, Stephen M Kaminsky, Dolan Sondhi, Clarisse L Jose, Christina C Price, Sarah F Brooks, Jason G Mezey, Ronald G Crystal
BACKGROUND: Peanuts are the most common food to provoke fatal or near-fatal anaphylactic reactions. Treatment with an anti-hIgE mAb is efficacious but requires frequent parenteral administration. OBJECTIVE: Based on the knowledge that peanut allergy is mediated by peanut-specific IgE, we hypothesized that a single administration of an adeno-associated virus (AAV) gene transfer vector encoding for anti-hIgE would protect against repeated peanut exposure in the host with peanut allergy...
June 23, 2016: Journal of Allergy and Clinical Immunology
Elizabeth Feuille, Anna Nowak-Węgrzyn
Oral immunotherapy (OIT) is a promising investigational therapy for food allergy. Clinical trials in peanut, milk, egg, and wheat allergy provide evidence that OIT can effectively desensitize a majority of individuals to a food allergen. While a portion of subjects demonstrate sustained unresponsiveness, the majority regain sensitivity with allergen avoidance. The safety and tolerability of OIT continue to limit its use in some patients. Virtually all studies report adverse reactions that are more frequent during dose escalation but may also occur during maintenance therapy...
2016: Annals of Nutrition & Metabolism
Christina S K Yee, Rima Rachid
Food allergy is a potentially life-threatening disease which affects up to 8% of children and 2-3% of adults. Increasing food allergy prevalence poses a major public health concern. Induction of desensitization to food allergens through oral immunotherapy (OIT) is an expanding area of study encompassing peanut, egg, milk, and other food allergens. OIT consists of administering incremental doses of food allergen to food-allergic patients, to induce a state of desensitization. Safety, tolerability, and efficacy all remain ongoing concerns...
April 2016: Current Allergy and Asthma Reports
Robert A Wood, Jennifer S Kim, Robert Lindblad, Kari Nadeau, Alice K Henning, Peter Dawson, Marshall Plaut, Hugh A Sampson
BACKGROUND: Although studies of oral immunotherapy (OIT) for food allergy have shown promise, treatment is frequently complicated by adverse reactions and, even when successful, has limited long-term efficacy because benefits usually diminish when treatment is discontinued. OBJECTIVE: We sought to examine whether the addition of omalizumab to milk OIT reduces treatment-related reactions, improves outcomes, or both. METHODS: This was a double-blind, placebo-controlled trial with subjects randomized to omalizumab or placebo...
April 2016: Journal of Allergy and Clinical Immunology
Dale T Umetsu, Rima Rachid, Lynda C Schneider
Food allergy is a major public health problem affecting nearly 10 % of children in most industrialized countries. Unfortunately, there are no effective therapies for food allergy, relegating patients to simply avoid the offending foods and treat reactions that occur on accidental exposure. Recently however, studies suggest that food immunotherapy may provide a promising new approach to food allergy, particularly using the oral form of immunotherapy (OIT). Enthusiasm for this approach though must be tempered because of the significant allergic reactions that often occur with OIT that tends to limit its use to patients with less severe disease...
2015: World Allergy Organization Journal
Masaya Takahashi, Shoichiro Taniuchi, Kazuhiko Soejima, Yasuko Hatano, Sohsaku Yamanouchi, Kazunari Kaneko
BACKGROUND: Rush oral immunotherapy (OIT) combined with omalizumab (OMB) has been reported to be an effective and safe treatment for severe milk allergies. However, no report has described long-term follow-up observations after OMB discontinuation. The purpose of this case report was to evaluate the safety and efficacy of rush OIT in combination with OMB during a long period of treatment. CASE PRESENTATION: A 5-year-old boy presented with a past history of two severe episodes of anaphylaxis (at the age of 2 and 3 years) after consuming small amounts of cow's milk (CM)...
2015: Allergy, Asthma, and Clinical Immunology
David El-Qutob
The off-label use of medicines is a common and extensive clinical practice. Omalizumab has been licensed for use in severe allergic asthma and chronic urticaria. Omalizumab dosing was based on body weight and baseline serum IgE concentration. All patients are required to have a baseline IgE between 30 and 700 IU/ml and body weight not more than 150 kg. The use of off-label drugs may lead to several problems including adverse effects and an increased risk/benefit balance. In this article, there are summarized off-label uses of omalizumab in the last recent years in diseases in which IgE maybe or certainly has a corner role such as allergic rhinitis, allergic bronchopulmonary aspergillosis, anaphylaxis, keratoconjunctivitis, food allergy, drug allergy, urticaria, angioedema, non-atopic asthma, atopic dermatitis, nasal polyps, Churg-Strauss syndrome, eosinophilic otitis media, chronic rhinosinusitis, bullous pemphigoid, contact dermatitis, and others...
February 2016: Clinical Reviews in Allergy & Immunology
Sakura Sato, Noriyuki Yanagida, Motohiro Ebisawa
The standardized therapeutic approach for food allergy is based on avoidance of allergens in foods. Oral immunotherapy (OIT) is a significant focus of food allergy research and appears to be effective in inducing desensitization. However, most patients receiving OIT have mild to moderate symptoms during the therapy, and it has not been clearly established whether OIT is effective in inducing permanent tolerance. Recently, novel therapeutic approaches for food allergy, or sublingual immunotherapy and epicutaneous immunotherapy using an anti-IgE monoclonal antibody (omalizumab), have been examined in some studies...
2015: Chemical Immunology and Allergy
A V Marzano, P Pigatto, A Cristaudo, F Ayala, O Rossi, G Senna, M Triggiani, R Asero
Chronic urticaria (CU) is a skin disorder characterized by transient, pruritic wheals persisting for longer than 6 weeks. According to the European Academy of Allergy and Clinical Immunology (EAACI) guidelines, CU can be categorized into two main types: chronic spontaneous urticaria (CSU), in which the wheals appear spontaneously, and inducible urticaria, that is triggered by physical agents. CSU may be due to triggering factors such as food allergens or infections, but in at least 40% of cases it is autoimmune in origin, caused by circulating autoantibodies anti-FcεR1 or anti-IgE, or autoreactive...
April 2015: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
Jeffrey R Stokes, Thomas B Casale
Omalizumab is a monoclonal anti-IgE antibody that has been used to treat allergic asthma for over a decade. The use of omalizumab to treat other diseases has largely been limited to case reports until the recently reported large multicenter studies that have established omalizumab as an effective treatment option for chronic spontaneous urticaria. The utility of omalizumab to treat nonallergic asthma and allergic rhinitis and the added safety and therapeutic benefits in combination with allergen immunotherapy have been demonstrated in placebo-controlled trials...
March 2015: Journal of Allergy and Clinical Immunology in Practice
Fulvio Braido, Angelo Corsico, Anthi Rogkakou, Vanessa Ronzoni, Ilaria Baiardini, Giorgio Walter Canonica
Allergen-specific immunotherapy (AIT) is considered the only treatment capable of modifying the natural history of allergic respiratory disorders. The possible adverse events related to AIT have, until now, limited its use to mild and controlled asthma. The pre-administration or concomitant treatment of AIT and omalizumab (an anti-IgE humanized antibody), recommended for the treatment of severe allergic asthma, could be useful in reducing the adverse events due to AIT and to allow its use in patients with more severe or uncontrolled asthma...
April 2015: Expert Review of Respiratory Medicine
Rahul Dutta, Pariket M Dubal, Jean Anderson Eloy
PURPOSE OF REVIEW: Rhinosinusitis affects an estimated one in seven adults in the United States. Otolaryngologists are intimately involved in the care of patients with rhinosinusitis and other upper airway inflammatory conditions through procedures such as endoscopic sinus surgery and, therefore, would benefit from a deeper understanding of the associated comorbidities and their management. Recent evidence has suggested several connections between the underlying disease of rhinosinusitis, seasonal allergies, and food allergies...
February 2015: Current Opinion in Otolaryngology & Head and Neck Surgery
Amelia Licari, Alessia Marseglia, Silvia Caimmi, Riccardo Castagnoli, Thomas Foiadelli, Salvatore Barberi, Gian Luigi Marseglia
Omalizumab is a recombinant humanized monoclonal antibody that reduces levels of circulating immunoglobulin E (IgE) and expression of IgE high-affinity receptors on mast cells and basophils, interrupting the subsequent allergic inflammatory cascade. Current indications for treatment with omalizumab in pediatric patients are clearly defined and are confined to moderate-to-severe uncontrolled allergic asthma and chronic spontaneous urticaria (CSU). Any other prescription can only be off label. Data available from clinical trials conducted in children suggest that omalizumab is clinically effective and generally well tolerated...
December 2014: Paediatric Drugs
Caroline Nilsson, Lennart Nordvall, S G O Johansson, Anna Nopp
Food allergy is common in children and young adults and may be difficult to diagnose and is at present treated with avoidance of the food in question. The aim of this report is to share our clinical experiences monitoring omalizumab treatment by basophil allergen threshold sensitivity, CD-sens. Five children, 6-16 years of age, with a severe milk allergy including episodes of anaphylaxis and IgE-antibodies, between 30 and 160 kUA/L to casein and alpha-lactalbumin (milk proteins), were treated with omalizumab...
October 2014: Asia Pacific Allergy
Sakura Sato, Noriyuki Yanagida, Kiyotake Ogura, Tomoyuki Asaumi, Yu Okada, Yumi Koike, Katsuhito Iikura, Akinori Syukuya, Motohiro Ebisawa
Allergen avoidance is the standard treatment for managing food allergies. Complete avoidance is difficult, and accidental exposure often occurs. Immunotherapy is a significant focus for treating food allergies, and oral immunotherapy (OIT) appears to be particularly effective in inducing desensitization. The majority of patients who receive OIT show increased threshold doses of their food allergen. The efficacy of OIT is different among food antigen, and milk OIT is relatively difficult to achieve tolerance...
September 2014: Asian Pacific Journal of Allergy and Immunology
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